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Nashwan AJ, Shaban MM, Kamugisha JB. Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa. Int Nurs Rev 2024. [PMID: 38613148 DOI: 10.1111/inr.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
AIM This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. BACKGROUND APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. SOURCES OF EVIDENCE Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. DISCUSSION Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. CONCLUSION The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. IMPLICATIONS FOR NURSING PRACTICE APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. IMPLICATIONS FOR NURSING POLICY AND HEALTH/SOCIAL POLICY The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Department of Nursing, Hamad Medical Corporation, Doha, Qatar
| | - Marwa M Shaban
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Giza, Egypt
| | - John Bosco Kamugisha
- Global Emergency Care, Masaka, Uganda
- Mbarara University of Science and Technology, Mbarara, Uganda
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Branda F, Giovanetti M, Sernicola L, Farcomeni S, Ciccozzi M, Borsetti A. Comprehensive Analysis of HIV-1 Integrase Resistance-Related Mutations in African Countries. Pathogens 2024; 13:102. [PMID: 38392840 PMCID: PMC10892843 DOI: 10.3390/pathogens13020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
The growing emergence of non-nucleoside reverse transcriptase inhibitor (NNRTI) HIV drug resistance in sub-Saharan Africa (SSA) led to the World Health Organization (WHO) recommending, in 2018, a transition to dolutegravir (DTG) as a first-line antiretroviral therapy (ART) in SSA. The broad HIV-1 genetic diversity in SSA could shape DTG effectiveness and the pattern of drug resistance mutations (DRMs) in this region. This study evaluated HIV-1 integrase (IN) DRMs and conserved regions among published groups M, N, O, and P HIV-1 sequences spanning forty years of the HIV epidemic during the transition of DTG-based ART. Overall, we found low levels of integrase strand transfer inhibitor (INSTI)-DRMs (<1%) across HIV groups between the years 1983 and 2023; however, it was unexpected to detect DRMs at statistically significantly higher frequencies in pre-INSTI (1983-2007) than in the INSTI (2008-2023) era. The variability of accessory INSTI-DRMs depended on the HIV subtypes, with implications for susceptibility to DTG. Our findings provide new perspectives on the molecular epidemiology and drug resistance profiles of INSTIs in SSA, emphasizing the need for ongoing surveillance and customized treatment approaches to address the continent's varied HIV subtypes and changing resistance patterns.
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Affiliation(s)
- Francesco Branda
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, 00128 Rome, Italy; (F.B.); (M.C.)
| | - Marta Giovanetti
- Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, 00128 Rome, Italy;
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte 30190-002, Brazil
- Climate Amplified Diseases and Epidemics (CLIMADE), Brasilia 70070-130, Brazil
| | - Leonardo Sernicola
- National HIV/AIDS Research Center (CNAIDS), Istituto Superiore di Sanità, 00161 Rome, Italy; (L.S.); (S.F.)
| | - Stefania Farcomeni
- National HIV/AIDS Research Center (CNAIDS), Istituto Superiore di Sanità, 00161 Rome, Italy; (L.S.); (S.F.)
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, 00128 Rome, Italy; (F.B.); (M.C.)
| | - Alessandra Borsetti
- National HIV/AIDS Research Center (CNAIDS), Istituto Superiore di Sanità, 00161 Rome, Italy; (L.S.); (S.F.)
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Centorotola G, Ziba MW, Cornacchia A, Chiaverini A, Torresi M, Guidi F, Cammà C, Bowa B, Mtonga S, Magambwa P, D’Alterio N, Scacchia M, Pomilio F, Muuka G. Listeria monocytogenes in ready to eat meat products from Zambia: phenotypical and genomic characterization of isolates. Front Microbiol 2023; 14:1228726. [PMID: 37711697 PMCID: PMC10498467 DOI: 10.3389/fmicb.2023.1228726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
The contamination of ready to eat foods (RTE) products due to Listeria monocytogenes could compromise the products safety becoming a great risk for the consumers. The high presence of L. monocytogenes in RTE products has been described worldwide, but few data are available about these products from African countries. The aims of this study were to report the presence of L. monocytogenes in Zambian RTE products, providing genomic characterization and data on similarity with African circulating strains using whole genome sequencing (WGS). A total of 304 RTE products, produced by different Zambian manufacturers, were purchased at retail, from major supermarkets located in Lusaka, Zambia, comprising 130 dairy and 174 meat products. L. monocytogenes was detected only in 18 (10.3%) RTE meat products of the 174 samples tested. The MLST analysis grouped the 18 L. monocytogenes isolates in 7 clonal complexes (CCs): CC1 (n = 5), CC2 (n = 4), CC9 (n = 4), CC5 (n = 2), CC121 (n = 1), CC155 (n = 1), and CC3 (n = 1). According to the cgMLST results, several clusters were detected, in particular belonging to hyper-virulent clones CC1 and CC2. Regarding the virulence factors, a complete L. monocytogenes Pathogenicity Island 3 (LIPI-3) was present both in the CC1 and CC3, in addition to LIPI-1. Several resistance genes and mobile genetic elements were detected, including Stress Islands, the bcrABC cassette and Tn6188_qac transposon, plasmids and intact prophages. Despite being a first preliminary work with a limited number of samples and isolates, this study helped to increase existing knowledge on contaminated RTE products in Zambia, confirming the presence of hyper-virulent L. monocytogenes CCs, which could play an important role in human diseases, posing a public health concern for consumers.
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Affiliation(s)
- Gabriella Centorotola
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Maureen Wakwamba Ziba
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Alessandra Cornacchia
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Alexandra Chiaverini
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Marina Torresi
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Fabrizia Guidi
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Cesare Cammà
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Benson Bowa
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Samson Mtonga
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Phelly Magambwa
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Nicola D’Alterio
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Massimo Scacchia
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Francesco Pomilio
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Geoffrey Muuka
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
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Zainudeen N, Mohammed L, Nyamful A, Adotey D, Osae S. A comparative review of the mineralogical and chemical composition of African major bauxite deposits. Heliyon 2023; 9:e19070. [PMID: 37636439 PMCID: PMC10450972 DOI: 10.1016/j.heliyon.2023.e19070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
Bauxite, which is the main raw material that aluminium is extracted from was discovered in Africa in the early 1900s. Currently, the production and export capacities of the African Bauxite ore are about a third of the World's total capacity. However, the processes leading to the final finished product of; surface mining of the ore, refining ore into alumina and finally extracting the pure aluminium metal in high energy consuming smelters that employ the Hall-Héroult electrolysis process; seldom take place inside Africa. The main goal of this work is to analyse the mineralogical and geochemical characteristics of bauxite deposits from some prominent bauxite producing and exporting countries of Africa in order to fashion out if a trend exist for the type of source rocks. Judging from the data obtained, gibbsite is found to be the main aluminium oxide in all the bauxite deposits with slight occurrence of boehmite in 3 out of the 13 deposits, while goethite is the main oxyhydroxide iron mineral. The compiled results of the various investigations highlighted the fact that the deposits are of diverse qualities with respect to world standard of major element content of bauxite; with average percentage concentration in the ranges as: Al2O3 (43.73-61.25), Fe2O3 (1.55-34.25), SiO2 (0.42-10.84); except two of the deposits with alumina content less than 40%. With evaluated silica moduli less than 8 for only two (2) of the deposits (4.76 and 6.94), the rest have higher moduli that ranges between (14.49 and 75.45). The higher percentage of iron oxide content (>20) in six (6) out of the 13 ore deposits, allowed the deposits to be grouped into three (3) categories of grades; high alumina ore, ferruginous ore, siliceous ore and combination of each. Source rock of the deposits were determined through geochemical and petrographic considerations of laterisation products of the rocks through evaluation of the weathering indices of; Chemical Index of Alteration which was in the range (97.16-99.98) while the Ruxton ratio ranged between (0.0133-0.2100); signifying the parent rock underwent intensive weathering process. This is indicative of the source rocks of the Bauxite deposits being either (i) anorthositic, (ii) argillite and dolerite, (iii) granulite and feldspathic gneiss, and/or, (iv) mafic-basaltic andesite igneous. Awareness of new and yet-to-commence emerging bauxite producing African countries was created, by highlighting the economic impact those respective countries will experience when that mining sector is developed for the aluminum industry at home and world at large.
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Affiliation(s)
- N.M. Zainudeen
- Department of Nuclear Sciences and Applications, School of Nuclear and Allied Sciences, University of Ghana, P.O. Box LG 80, Legon, Accra, Ghana
- Institute of Scientific & Technological Information, Council for Scientific and Industrial Research, P. O. Box CT 2211, Cantonments, Accra, Ghana
| | - L. Mohammed
- Institute of Industrial Research, Council for Scientific and Industrial Research, P. O. Box LG 587, Legon, Accra, Ghana
| | - A. Nyamful
- Department of Nuclear Engineering, School of Nuclear and Allied Sciences, University of Ghana, P.O. Box LG 80, Legon, Accra, Ghana
| | - D. Adotey
- Department of Nuclear Sciences and Applications, School of Nuclear and Allied Sciences, University of Ghana, P.O. Box LG 80, Legon, Accra, Ghana
| | - S.K. Osae
- Department of Nuclear Sciences and Applications, School of Nuclear and Allied Sciences, University of Ghana, P.O. Box LG 80, Legon, Accra, Ghana
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Yenet A, Nibret G, Tegegne BA. Challenges to the Availability and Affordability of Essential Medicines in African Countries: A Scoping Review. Clinicoecon Outcomes Res 2023; 15:443-458. [PMID: 37332489 PMCID: PMC10276598 DOI: 10.2147/ceor.s413546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction The availability and affordability of safe, effective, accessible, and high-quality essential medicines is a critical benchmark for achieving the right to good health, and it is also one of the goals of the global health development agenda. To that end, it is critical to conduct rigorous studies to identify the major challenges confronting developing countries, particularly those in Africa. Objective The purpose of this review was to identify the major challenges that Africans face in obtaining reasonably priced and readily available essential medicines. Methods Generally the Boolean operators "AND" and "OR" were employed. Making progress also involves using duplicate checks, field definitions, and comparisons of articles and criteria. The analysis included all English-language papers published in any African country between 2005 and 2022, depending on the year of publication. The technique searches electronic databases for key phrases related to essential medication availability and affordability, such as PubMed, Web of Science, Scopus, Science Direct, Plos Medicine, and Google Scholar. Results A total of 91 articles; by using search engines and handpicking including duplicates, were primarily searched. The electronic database search earned 78 articles while only eleven studies met the criteria for review and were reviewed of which 5 (50%) were from East African countries. Inadequate human resources, financial constraints, high cost of available medications on the market, poor inventory management, manual consumption forecasting, inefficiencies in drug registration, and trade-related aspects of intellectual property rights agreement regulations are all obstacles to the availability of essential medicines in African nations. Conclusion This review revealed that in Africa, the availability and affordability of essential medicines face numerous challenges. The primary challenge, according to the review research, is a lack of adequate financing to pay for an appropriate set of essential medications, which account for a significant portion of household spending.
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Affiliation(s)
- Aderaw Yenet
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getinet Nibret
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bantayehu Addis Tegegne
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Nemadodzi LE, Managa GM, Prinsloo G. The Use of Gonimbrasia belina (Westwood, 1849) and Cirina forda (Westwood, 1849) Caterpillars (Lepidoptera: Sarturniidae) as Food Sources and Income Generators in Africa. Foods 2023; 12:foods12112184. [PMID: 37297431 DOI: 10.3390/foods12112184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/18/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Gonimbrasia belina (mopane worm) and Cirina forda caterpillars (Lepidoptera: Saturniidae) are mostly found in shrubs and trees, from where they are collected as larvae and are widely consumed across southern Africa by rural and increasingly urban populations. These caterpillars are among the most prominent, traded, and economically beneficial edible insects found in Western African countries, but also in South Africa, Zimbabwe, Botswana, and the Democratic Republic of the Congo. Over the years, these caterpillars have evolved from being part of the diet in various communities to playing a vital role in income generation. In addition, consumption of G. belina and C. forda caterpillars as potential food sources has gained momentum due to their potential for contributing to livelihoods and mitigating food security challenges across Africa while providing significant benefits to developing countries on a socio-economic and ecological level. Edible caterpillars serve as a good source of rich nutrients such as proteins, fatty acids, and micronutrients and can be used in formulating nutrient-dense complementary foods. However, limited information is available, specifically on different trees that serve as hosts to these caterpillars, as they depend on the leaves as their only source of food. In addition, the review aims to critique and document knowledge on the nutritional benefits, acceptance of the use of these caterpillars as food security, commercial value, and level of acceptance towards the utilization of caterpillars as food sources.
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Affiliation(s)
- Lufuno Ethel Nemadodzi
- Department of Agriculture and Animal Health, University of South Africa, Private Bag X6, Florida 1710, South Africa
| | - Gudani Millicent Managa
- Department of Agriculture and Animal Health, University of South Africa, Private Bag X6, Florida 1710, South Africa
| | - Gerhard Prinsloo
- Department of Agriculture and Animal Health, University of South Africa, Private Bag X6, Florida 1710, South Africa
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Ferretti F, Mariani M, Sarti E. Physician density: will we ever close the gap? BMC Res Notes 2023; 16:84. [PMID: 37211602 DOI: 10.1186/s13104-023-06353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE Physician density is a crucial element of a well-functioning health system. Previous research has investigated factors affecting country-level physician supply. To date, however, no evidence has been provided about the patterns of convergence in physician density among countries. This paper thus tested club convergence in physician density in 204 countries worldwide from 1990 to 2019. A nonlinear time-varying factor model was adopted to identify potential clubs, wherein groups of countries tend to converge towards the same level of physician density. Our primary purpose was to document the potential long-lasting disparity in future global physician distribution. RESULTS Despite physician density increasing in all regions globally from 1990 to 2019, we found no evidence in favor of the hypothesis of global convergence. Conversely, the clustering algorithm successfully identified three main patterns (i.e., three final clubs). With few exceptions, the results indicated an uneven physician distribution between the majority of North and Sub-Saharan African countries (where physician density would remain well below the estimated threshold of at least 70% of the Universal Health Coverage Services Index) and the rest of the world. These findings support the WHO's global strategy to reverse the chronic under-investment in human resources for health.
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Affiliation(s)
- Fabrizio Ferretti
- Department of Communication and Economics, University of Modena and Reggio Emilia, Viale Allegri 9, 42121, Reggio Emilia, Italy.
| | - Michele Mariani
- Department of Communication and Economics, University of Modena and Reggio Emilia, Viale Allegri 9, 42121, Reggio Emilia, Italy
| | - Elena Sarti
- Department of Economics - Marco Biagi, University of Modena and Reggio Emilia, Via Berengario 51, 41121, Modena, Italy
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Gannon BM, Sombié OO, Zeba AN, Nama GM, Bekele TH, Woldeyohannes M, van Stuijvenberg ME, Dhansay MA, Urio EM, Kaliwile C, Chileshe J, Kalungwana N, Davis CR, Grahn M, Tanumihardjo SA. Comparison of Total Body Vitamin A Stores Using Individual versus Population 13C-Natural Abundance of Serum Retinol in Preschool Children and Women Residing in 6 Diverse African Countries. J Nutr 2023; 153:949-957. [PMID: 36822237 PMCID: PMC10367224 DOI: 10.1016/j.tjnut.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Stable isotope techniques using 13C to assess vitamin A (VA) dietary sources, absorption, and total body VA stores (TBSs) require determination of baseline 13C abundance. 13C-natural abundance is approximately 1.1% total carbon, but varies with foods consumed, supplements taken, and food fortification with synthetic retinyl palmitate. OBJECTIVES We determined 13C variation from purified serum retinol and the resulting impact on TBSs using pooled data from preschool children in Burkina Faso, Cameroon, Ethiopia, South Africa, Tanzania, and Zambia and Zambian women. METHODS Seven studies included children (n = 639; 56 ± 25 mo; 48% female) and one in women (n = 138; 29 ± 8.5 y). Serum retinol 13C-natural abundance was determined using GC-C-IRMS. TBSs were available in 7 studies that employed retinol isotope dilution (RID). Serum CRP and α1-acid-glycoprotein (AGP) were available from 6 studies in children. Multivariate mixed models assessed the impact of covariates on retinol 13C. Spearman correlations and Bland-Altman analysis compared serum and milk retinol 13C and evaluated the impact of using study- or global-retinol 13C estimates on calculated TBSs. RESULTS 13C-natural abundance (%, median [Q1, Q3]) differed among countries (low: Zambia, 1.0744 [1.0736, 1.0753]; high: South Africa, 1.0773 [1.0769, 1.0779]) and was associated with TBSs, CRP, and AGP in children and with TBSs in women. 13C-enrichment from serum and milk retinol were correlated (r = 0.52; P = 0.0001). RID in children and women using study and global estimates had low mean bias (range, -3.7% to 2.2%), but larger 95% limits of agreement (range, -23% to 37%). CONCLUSIONS 13C-natural abundance is different among human cohorts in Africa. Collecting this information in subgroups is recommended for surveys using RID. When TBSs are needed on individuals in clinical applications, baseline 13C measures are important and should be measured in all enrolled subjects.
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Affiliation(s)
- Bryan M Gannon
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, United States.
| | - Olivier O Sombié
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Augustin N Zeba
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - Martha E van Stuijvenberg
- Non-Communicable Diseases Research Unit, South African Medical Research Council; Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Muhammad A Dhansay
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa; Burden of Disease Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa; Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | | | - Chisela Kaliwile
- National Food and Nutrition Commission (NFNC), Public Health and Community Nutrition Unit, Lusaka, Zambia
| | | | | | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Michael Grahn
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, United States.
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9
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Suri DJ, Sombié OO, Zeba AN, Nama GM, Bekele TH, Woldeyohannes M, van Stuijvenberg ME, Dhansay MA, Urio EM, Loechl CU, Gannon BM, Davis CR, Grahn M, Suchdev PS, Tanumihardjo SA. Association between Biomarkers of Inflammation and Total Liver Vitamin A Reserves Estimated by 13C-Retinol Isotope Dilution among Preschool Children in 5 African Countries. J Nutr 2023; 153:622-635. [PMID: 36931745 DOI: 10.1016/j.tjnut.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/28/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Vitamin A (VA) assessment is important for targeting public health programs. Retinol isotope dilution (RID) is a sensitive method to estimate total body VA stores (TBSs) and total liver reserves (TLRs), but the impact of subclinical inflammation on RID is unclear. OBJECTIVE We determined the association between TBSs and TLRs, estimated by RID, and inflammation among preschool children without clinical infection in Burkina Faso, Cameroon, Ethiopia, South Africa, and Tanzania. METHODS Five studies (n = 532; 47.9 ± 8.3 mo; 49.0% male) included 13C-RID and measurement of inflammation markers, CRP, and α1-acid glycoprotein (AGP). Spearman correlations were used to evaluate TBSs and TLRs with inflammation biomarkers. Wilcoxon and Kruskal-Wallis tests were used to compare TBSs and TLRs by inflammation categories [normal vs. elevated CRP (>5 mg/L) or AGP (>1 g/L)] and inflammation stage [reference, incubation (elevated CRP), early convalescence (elevated CRP and AGP), and late convalescence (elevated AGP)]. RESULTS Complete data were available for 439 children. Median (Q1, Q3) TLRs ranged from 0.12 (0.07, 0.18) μmol/g in Ethiopia to 1.10 (0.88, 1.38) μmol/g in South Africa. Elevated CRP ranged from 4% in Burkina Faso to 42% in Cameroon, and elevated AGP from 20% in Tanzania to 58% in Cameroon. Pooled analysis (excluding Cameroon) showed a negative correlation between TBSs and AGP (ρ = -0.131, P = 0.01). Children with elevated AGP had higher probability of having lower TBSs (probability = 0.61, P = 0.002). TBSs differed among infection stages (P = 0.020). Correlations between TLRs and CRP or AGP were not significant. CONCLUSIONS No indication of systematic bias in RID-estimated TLRs was found due to subclinical inflammation among preschool children. The inverse relationship between TBSs and AGP may reflect decreased stores after infection or an effect of inflammation on isotope partitioning. Further research should investigate potential confounding variables to improve TBS-estimate validity.
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Affiliation(s)
- Devika J Suri
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
| | - Olivier O Sombié
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Augustin N Zeba
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - Martha E van Stuijvenberg
- Non-Communicable Diseases Research Unit, South African Medical Research Council, South Africa; Division of Human Nutrition, Stellenbosch University, South Africa
| | - Muhammad A Dhansay
- Division of Human Nutrition, Stellenbosch University, South Africa; Burden of Disease Research Unit, South African Medical Research Council, South Africa; Department of Paediatrics and Child Health, Stellenbosch University, South Africa
| | | | - Cornelia U Loechl
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Bryan M Gannon
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher R Davis
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael Grahn
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
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10
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Mgbere O, Nwabuko OC, Olateju OA, Adepoju OE, Liaw W, Darkoh C, Essien EJ. Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications. Ther Adv Infect Dis 2023; 10:20499361231202116. [PMID: 37779674 PMCID: PMC10540606 DOI: 10.1177/20499361231202116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/02/2023] [Indexed: 10/03/2023] Open
Abstract
Background The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic. Methods This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios. Results A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% (n = 15) with medium burden and 22.6% (n = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the first 1-year period with significant variations (p < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/105 and 315.933/105 populations were recorded with significant correlation (r = 0.863, p < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.
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Affiliation(s)
- Osaro Mgbere
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, 5055 Medical Cir. Houston, TX 77204-5000, USA
- Institute of Community Health, University of Houston College of Pharmacy, Houston, TX, USA
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
- Public Health Science and Surveillance Division, Houston Health Department, Houston, TX, USA
| | - Ogbonna Collins Nwabuko
- Department of Haematology and Blood Transfusion, Federal Medical Centre, Umuahia, Abia State, Nigeria
- Department of Haematology and Blood Transfusion, Faculty of Basic Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Olajumoke A. Olateju
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Omolola E. Adepoju
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
| | - Winston Liaw
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
| | - Charles Darkoh
- University of Texas Health Science Center, School of Public Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, Center for Infectious Diseases, Houston, TX, USA
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Microbiology and Infectious Diseases Program, Houston, TX, USA
| | - Ekere James Essien
- Institute of Community Health, University of Houston College of Pharmacy, Houston, TX, USA
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
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11
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Dosso M, Cassi L, Mescheba W. Towards regional scientific integration in Africa? Evidence from co-publications. Res Policy 2023; 52:104630. [PMID: 36597459 PMCID: PMC9746314 DOI: 10.1016/j.respol.2022.104630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 08/21/2022] [Accepted: 09/12/2022] [Indexed: 01/07/2023]
Abstract
Regional scientific integration is a critical pathway for the development of an integrated African research area and knowledge-based society. On the African continent, progress in scientific production and integration has remained limited, mostly led by a global or international agenda, and bound to a few top publishing nations. The high-level policy commitments and the accumulated policies and strategies developed and pursued under the various intertwined sub-regional economic groupings have, to date, only diversely contributed to policy alignment and coordination in the area of science, technology, and innovation (STI) across Africa. In this context, this paper provides a first and hence original assessment of the role of region-specific factors in shaping scientific collaboration on the continent. For this purpose, our study builds upon the proximity approach to analyse the determinants of scientific collaboration between African countries, using co-publications data from Thomson Reuters' Web of Science database as a proxy of such collaboration. Our results suggest that the majority of African regional economic communities (RECs) have not yet had a significant effect on scientific co-publication. Nevertheless, some important region-specific factors do seem to be at play, such as a shared ethnical language, membership in the African and Malagasy Council for Higher Education (CAMES), and the presence of a common European partner as a third partner in co-publication. Existing policies aimed at the development of an Africa-wide research area should aim to leverage existing and emerging regional excellence networks and novel coordination models to accelerate the process of scientific integration in Africa.
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Affiliation(s)
- Mafini Dosso
- European Commission, Joint Research Centre, Dir. B. Growth and Innovation, Unit B.3, Urban and Territorial Development, Seville, Spain
- Corresponding author.
| | - Lorenzo Cassi
- Paris School of Economics - University of Paris 1 Panthéon-Sorbonne, Paris, France
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12
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Ogunleye OO, Godman B, Fadare JO, Mudenda S, Adeoti AO, Yinka-Ogunleye AF, Ogundele SO, Oyawole MR, Schönfeldt M, Rashed WM, Galal AM, Masuka N, Zaranyika T, Kalungia AC, Malande OO, Kibuule D, Massele A, Chikowe I, Khuluza F, Taruvinga T, Alfadl A, Malik E, Oluka M, Opanga S, Ankrah DNA, Sefah IA, Afriyie D, Tagoe ET, Amu AA, Msibi MP, Etando A, Alabi ME, Okwen P, Niba LL, Mwita JC, Rwegerera GM, Kgatlwane J, Jairoun AA, Ejekam C, Mavenyengwa RT, Murimi-Worstell I, Campbell SM, Meyer JC. Coronavirus Disease 2019 (COVID-19) Pandemic across Africa: Current Status of Vaccinations and Implications for the Future. Vaccines (Basel) 2022; 10:vaccines10091553. [PMID: 36146631 PMCID: PMC9504201 DOI: 10.3390/vaccines10091553] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/06/2022] [Accepted: 09/10/2022] [Indexed: 12/15/2022] Open
Abstract
The introduction of effective vaccines in December 2020 marked a significant step forward in the global response to COVID-19. Given concerns with access, acceptability, and hesitancy across Africa, there is a need to describe the current status of vaccine uptake in the continent. An exploratory study was undertaken to investigate these aspects, current challenges, and lessons learnt across Africa to provide future direction. Senior personnel across 14 African countries completed a self-administered questionnaire, with a descriptive analysis of the data. Vaccine roll-out commenced in March 2021 in most countries. COVID-19 vaccination coverage varied from low in Cameroon and Tanzania and up to 39.85% full coverage in Botswana at the end of 2021; that is, all doses advocated by initial protocols versus the total population, with rates increasing to 58.4% in Botswana by the end of June 2022. The greatest increase in people being fully vaccinated was observed in Uganda (20.4% increase), Botswana (18.5% increase), and Zambia (17.9% increase). Most vaccines were obtained through WHO-COVAX agreements. Initially, vaccination was prioritised for healthcare workers (HCWs), the elderly, adults with co-morbidities, and other at-risk groups, with countries now commencing vaccination among children and administering booster doses. Challenges included irregular supply and considerable hesitancy arising from misinformation fuelled by social media activities. Overall, there was fair to reasonable access to vaccination across countries, enhanced by government initiatives. Vaccine hesitancy must be addressed with context-specific interventions, including proactive programmes among HCWs, medical journalists, and the public.
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Affiliation(s)
- Olayinka O. Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Correspondence:
| | - Joseph O. Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti 362103, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | - Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka P.O. Box 32379, Zambia
| | - Adekunle O. Adeoti
- Department of Medicine, Ekiti State University Teaching Hospital, Ado Ekiti 360211, Nigeria
| | | | - Sunday O. Ogundele
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos 100271, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Modupe R. Oyawole
- Department of Pharmacy, Lagos State University Teaching Hospital, Lagos 100271, Nigeria
| | - Marione Schönfeldt
- Child, Youth and School Health Directorate, National Department of Health, Pretoria 0083, South Africa
| | - Wafaa M. Rashed
- Children’s Cancer Hospital, Egypt-57357 (CCHE-57357), Cairo 11441, Egypt
| | - Ahmad M. Galal
- Biomedical Research Department, Armed Forces College of Medicine, Cairo 11774, Egypt
| | - Nyasha Masuka
- CIMAS, Cimas House, Borrowdale Office Park, Borrowdale Road, Harare P.O. Box 1243, Zimbabwe
| | - Trust Zaranyika
- Department of Medicine, University of Zimbabwe College of Health Sciences, Harare P.O. Box MP167, Zimbabwe
| | - Aubrey C. Kalungia
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
| | - Oliver O. Malande
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Department of Child Health and Paediatrics, Egerton University, Nakuru P.O.Box 536, Kenya
- East Africa Centre for Vaccines and Immunization (ECAVI), Namela House, Naguru, Kampala P.O. Box 3040, Uganda
| | - Dan Kibuule
- Department of Pharmacology & Therapeutics, Busitema University, Mbale P.O. Box 236, Uganda
| | - Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
| | - Ibrahim Chikowe
- Pharmacy Department, Formerly College of Medicine, Kamuzu University of Health Sciences (KUHeS), Blantyre P.O. Box 278, Malawi
| | - Felix Khuluza
- Pharmacy Department, Formerly College of Medicine, Kamuzu University of Health Sciences (KUHeS), Blantyre P.O. Box 278, Malawi
| | - Tinotenda Taruvinga
- Department of Global Health and Development (GHD), London School of Hygiene and Tropical Medicine (LSHTM), London WC1E 7TH, UK
| | - Abubakr Alfadl
- National Medicines and Poisons Board, Federal Ministry of Health, Khartoum P.O. Box 303, Sudan
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah 51911, Saudi Arabia
| | - Elfatih Malik
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Margaret Oluka
- Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Sylvia Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
| | - Daniel N. A. Ankrah
- Department of Pharmacy, Korle Bu Teaching Hospital, Accra P.O. Box 77, Ghana
| | - Israel A. Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Hohoe PMB 31, Ghana
| | - Daniel Afriyie
- Pharmacy Department, Ghana Police Hospital, Accra P.O. Box CT104, Ghana
| | - Eunice T. Tagoe
- Department of Management Science, University of Strathclyde, Glasgow G4 0QU, UK
| | - Adefolarin A. Amu
- Pharmacy Department, Eswatini Medical Christian University, P.O. Box A624, Swazi Plaza, Mbabane H100, Eswatini
| | - Mlungisi P. Msibi
- Faculty of Health Sciences, Department of Medical Laboratory Sciences, Eswatini Medical Christian University, Swazi Plaza P.O. Box A624, Mbabane H100, Eswatini
| | - Ayukafangha Etando
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Eswatini Medical Christian University, Swazi Plaza P.O. Box A624, Mbabane H100, Eswatini
| | - Mobolaji E. Alabi
- School of Pharmaceutical Sciences, College of Health Sciences, University of Kwazulu-natal (UKZN), Durban 4001, South Africa
| | - Patrick Okwen
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda 5175, Cameroon
- Faculty of Health and Medical Sciences, Adelaide University, Adelaide 5005, Australia
| | - Loveline Lum Niba
- Effective Basic Services (eBASE) Africa, Ndamukong Street, Bamenda 5175, Cameroon
- Department of Public Health, University of Bamenda, Bambili P.O. Box 39, Cameroon
| | - Julius C. Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone P.O. Box 70480, Botswana
| | - Godfrey M. Rwegerera
- Department of Medicine, Sir Ketumile Masire Teaching Hospital, Gaborone P.O. Box 70480, Botswana
| | - Joyce Kgatlwane
- Department of Pharmacy, University of Botswana, Gaborone P.O. Box 70480, Botswana
| | - Ammar A. Jairoun
- Health and Safety Department, Dubai Municipality, Dubai P.O. Box 67, United Arab Emirates
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Chioma Ejekam
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos PMB 21266, Nigeria
| | - Rooyen T. Mavenyengwa
- Medical Microbiology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe
| | - Irene Murimi-Worstell
- School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences, Boston, MA 02115, USA
| | - Stephen M. Campbell
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 02084, South Africa
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Rahman MM, Alam K, Khanam R. Socio-economic factors affecting high infant and child mortality rates in selected African countries: does globalisation play any role? Global Health 2022; 18:69. [PMID: 35799303 PMCID: PMC9261177 DOI: 10.1186/s12992-022-00855-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/08/2022] [Indexed: 11/14/2022] Open
Abstract
Background Despite the declining trends worldwide, infant and child mortality rates are still high in many African countries. These high rates are problematic; therefore, this study attempts to explore the contributing factors that cause high infant and child mortality rates in 14 African countries using panel data for the period of 2000–2018. In particular, the role globalisation is explored. Methods The panel corrected standard error (PCSE), the Feasible generalized least square (FGLS) models, and the pair-wise Granger causality test have been applied as methodological approaches. Results The public health expenditure, numbers of physicians, globalization, economic development, education, good governance, and HIV prevalence rate have been revealed as the determinants of infant and child mortality in these countries. All these variables except the HIV prevalence rate negatively affect the infant and child mortality rates, while the HIV prevalence rate is found to be positive. Bidirectional and unidirectional causal relationships between the variables are also attained. Conclusions Effective socio-economic policy priority with due consideration of globalization should be emphasized to reduce infant and child mortality rates in these countries.
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Affiliation(s)
- Mohammad Mafizur Rahman
- School of Business, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Khosrul Alam
- Department of Economics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh.
| | - Rasheda Khanam
- School of Business, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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14
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Jaca A, Malinga T, Iwu-Jaja CJ, Nnaji CA, Okeibunor JC, Kamuya D, Wiysonge CS. Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review. Int J Environ Res Public Health 2022; 19:587. [PMID: 35010844 PMCID: PMC8744844 DOI: 10.3390/ijerph19010587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022]
Abstract
Universal health coverage (UHC) is defined as people having access to quality healthcare services (e.g., treatment, rehabilitation, and palliative care) they need, irrespective of their financial status. Access to quality healthcare services continues to be a challenge for many people in low- and middle-income countries (LMICs). The aim of this study was to conduct a scoping review to map out the health system strengthening strategies that can be used to attain universal health coverage in Africa. We conducted a scoping review and qualitatively synthesized existing evidence from studies carried out in Africa. We included studies that reported interventions to strengthen the health system, e.g., financial support, increasing work force, improving leadership capacity in health facilities, and developing and upgrading infrastructure of primary healthcare facilities. Outcome measures included health facility infrastructures, access to medicines, and sources of financial support. A total of 34 studies conducted met our inclusion criteria. Health financing and developing health infrastructure were the most reported interventions toward achieving UHC. Our results suggest that strengthening the health system, namely, through health financing, developing, and improving the health infrastructure, can play an important role in reaching UHC in the African context.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
| | - Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
| | - Chinwe Juliana Iwu-Jaja
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa;
| | - Chukwudi Arnest Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa
| | | | - Dorcas Kamuya
- Department of Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Nairobi 43640-00100, Kenya;
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town 8000, South Africa; (T.M.); (C.A.N.); (C.S.W.)
- School of Public Health and Family Medicine, University of Cape Town, Cape Town 8000, South Africa
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
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15
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Chepkurui V, Amponsah-Dacosta E, Haddison EC, Kagina BM. Characterization of National Immunization Programs in the Context of Public Health Emergencies: A Case Study of 13 Countries in the WHO Africa Region. Front Public Health 2021; 9:736532. [PMID: 34650952 PMCID: PMC8505981 DOI: 10.3389/fpubh.2021.736532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Multiple public health emergencies (PHEs) experienced annually in the World Health Organisation (WHO) Africa region affect the provision of health services, including immunization. However, there is limited information on the performance of national immunization programs (NIPs) in WHO Africa countries that experience PHEs. This study assessed PHEs (armed conflicts, disasters, and disease outbreaks) and the performance of NIPs using global and regional immunization targets outlined for the Decade of Vaccines. Thirteen beneficiary countries of PHE mitigation funds from the African Public Health Emergency Fund were used as case studies. Data on PHEs and immunization indicators between 2010 and 2019 in selected countries were extracted from different PHE databases and the WHO/UNICEF immunization database, respectively. The data were stratified by country and summarized using descriptive statistics. Mann-Whitney U test was done to determine the association between the frequency of PHEs and the performance of NIPs. There were 175 disease outbreaks, 288 armed conflicts, and 318 disasters in the examined countries between 2010 and 2019. The Democratic Republic of Congo had the highest total PHE count (n = 208), while Liberia had the lowest (n = 20). Only three of the 13 countries had a median coverage value for the third dose of the combined Diphtheria, Tetanus, and Pertussis vaccine (DTP3) that had attained the target for ≥90% immunization coverage. Higher counts of armed conflict and total PHEs were associated with not meeting immunization targets for national DTP3 coverage of ≥90% and Maternal and Neonatal Tetanus elimination, p < 0.01. It was clear that in the WHO Africa region, PHEs are prevalent, irrespective of a country’s level of immunization maturity, and have the potential to derail the progress of NIPs in the absence of effective interventions. As we transition toward the Immunization Agenda 2030, we recommend that the WHO Africa region prioritizes interventions to mitigate the impacts of PHEs on NIPs.
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Affiliation(s)
- Viola Chepkurui
- Faculty of Health Science, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Edina Amponsah-Dacosta
- Faculty of Health Science, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Benjamin Mugo Kagina
- Faculty of Health Science, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Vaccines for Africa Initiative, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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16
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Shalash A, Okubadejo NU, Doumbe J, Ojo OO, Hamid E, Kuate C, Calvo S, Helmi A, Agabi OP, Essam M, Aguado L, Elrassas H, Roushdy T, Tanner CM, Cubo E. Translation, Validation, Diagnostic Accuracy, and Reliability of Screening Questionnaire for Parkinsonism in Three African Countries. J Parkinsons Dis 2021; 10:1113-1122. [PMID: 32568112 DOI: 10.3233/jpd-202040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Availability of validated Parkinson's disease (PD) questionnaires in languages spoken in Africa will enable the conduct of epidemiological studies. OBJECTIVE The aims of the current study were to develop cross-cultural translated and validated Arabic and French versions of a PD screening questionnaire, and determine its diagnostic accuracy for recognition of parkinsonism in early and moderate-advanced PD in three countries (Cameroon (French), Egypt (Arabic), and Nigeria (English)). METHODS This cross-sectional study screened 159 participants (81 PD and 78 controls) using the PD screening questionnaire. The questionnaire was translated into Arabic and French versions using standard protocols. Cognitive function was assessed using the Montreal Cognitive Assessment and the Identification and Intervention for Dementia in Elderly Africans cognitive screen. Co-morbidity burden was documented using the Charlson Comorbidity Index. PD severity and stage were evaluated using the MDS Unified Parkinson Disease Rating Scale and the Hoehn and Yahr scale respectively. RESULTS Both PD patients and controls were matched regarding age, gender, education, and co-morbidity burden. The PD screening questionnaire scores were significantly higher in PD (median 8.0, IQR 6.0-10.0) in contrast to controls (0.0, IQR 0.0-0.0) (p < 0.0001), with a similar pattern and level of significance across all country sites. In ROC analysis, the questionnaire demonstrated high diagnostic accuracy for PD overall, with an AUC of 0.992 (95% CI 0.981-1.002). CONCLUSION The Arabic, French, and English versions of this PD screening questionnaire are valid and accurate screening instruments for recognition of Parkinsonism. This paves the way for conducting epidemiological studies in many African countries.
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Affiliation(s)
- Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Njideka U Okubadejo
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Jacques Doumbe
- Department of Neurology, University of Douala, Douala, Cameroon
| | - Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Callixte Kuate
- Department of Neurology, University of Douala, Douala, Cameroon
| | - Sara Calvo
- Neurology Department, University Hospital, Burgos, Spain
| | - Asmaa Helmi
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Osigwe P Agabi
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Mohamed Essam
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Laura Aguado
- Neurology Department, University Hospital, Burgos, Spain
| | - Hanan Elrassas
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Roushdy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Caroline M Tanner
- Department of Neurology, Weill Institute for Neurosciences, University of California - San Francisco, San Francisco, CA, USA
| | - Esther Cubo
- Neurology Department, University Hospital, Burgos, Spain
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Oyeyemi OT, Okunlola OA, Adebayo AD. Assessment of schistosomiasis endemicity and preventive treatment on coronavirus disease 2019 outcomes in Africa. New Microbes New Infect 2020; 38:100821. [PMID: 33251016 PMCID: PMC7679227 DOI: 10.1016/j.nmni.2020.100821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/25/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023] Open
Abstract
Since the coronavirus disease 2019 (COVID-19) pandemic, attention has been drawn to the possible interactions between the deadly disease and a few other infections. Although schistosomiasis and other neglected tropical diseases have been proposed to influence susceptibility to COVID-19, no study has looked into this. This study therefore investigated the impact of schistosomiasis on the transmission of COVID-19 and also evaluated the role of praziquantel treatment coverage on COVID-19 outcomes in African countries. The schistosomiasis endemicity and the preventive chemotherapy coverage index statuses were obtained from the World Health Organization databank. COVID-19 data were obtained from the Worldometer COVID-19 report. The data were adjusted and the percentage of COVID-19 cases confirmed, and active cases, recovery and deaths were computed. The COVID-19 outcomes were evaluated relative to schistosomiasis endemicity and treatment coverage. COVID-19 outcomes, especially active cases and recovery rates, were significantly improved in schistosomiasis nonendemic African countries (p < 0.05). While COVID-19 confirmed cases were significantly higher in countries with >75% schistosomiasis preventive chemotherapy coverage index (p < 0.05), improved COVID-19 outcomes were observed relative to active cases and recovery in countries with >75% preventive chemotherapy coverage index (p > 0.05). Schistosomiasis endemicity may be associated with negative COVID-19 outcomes, and higher praziquantel treatment coverage could reduce COVID-19 active cases and improve the recovery rate.
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Affiliation(s)
- O T Oyeyemi
- Department of Biological Sciences, Department of Mathematics, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - O A Okunlola
- Department of Mathematics, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - A D Adebayo
- Department of Remote Sensing and GIS, Federal University of Technology, Akure, Ondo State, Nigeria
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González-Alcaide G, Menchi-Elanzi M, Nacarapa E, Ramos-Rincón JM. HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships. Global Health 2020; 16:83. [PMID: 32943058 PMCID: PMC7499968 DOI: 10.1186/s12992-020-00609-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 08/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND HIV/AIDS has attracted considerable research attention since the 1980s. In the current context of globalization and the predominance of cooperative work, it is crucial to analyze the participation of the countries and regions where the infection is most prevalent. This study assesses the participation of African countries in publications on the topic, as well as the degree of equity or influence existing in North-South relations. METHODS We identified all articles and reviews of HIV/AIDS indexed in the Web of Science Core Collection. We analyzed the scientific production, collaboration, and contributions from African and Middle Eastern countries to scientific activity in the region. The concept of leadership, measured through the participation as the first author of documents in collaboration was used to determine the equity in research produced through international collaboration. RESULTS A total of 68,808 documents published from 2010 to 2017 were analyzed. Researchers from North America and Europe participated in 82.14% of the global scientific production on HIV/AIDS, compared to just 21.61% from Africa and the Middle East. Furthermore, the publications that did come out of these regions was concentrated in a small number of countries, led by South Africa (41% of the documents). Other features associated with HIV/AIDS publications from Africa include the importance of international collaboration from the USA, the UK, and other European countries (75-93% of the documents) and the limited participation as first authors that is evident (30 to 36% of the documents). Finally, the publications to which African countries contributed had a notably different disciplinary orientation, with a predominance of research on public health, epidemiology, and drug therapy. CONCLUSIONS It is essential to foster more balance in research output, avoid the concentration of resources that reproduces the global North-South model on the African continent, and focus the research agenda on local priorities. To accomplish this, the global North should strengthen the transfer of research skills and seek equity in cooperative ties, favoring the empowerment of African countries. These efforts should be concentrated in countries with low scientific activity and high incidence and prevalence of the disease. It is also essential to foster intraregional collaborations between African countries.
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Affiliation(s)
| | - Marouane Menchi-Elanzi
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain
| | - Edy Nacarapa
- Infectious Disease Division, Carmelo Hospital of Chókwè - Daughters of Charity, Saint Vincent of Paul, Chókwè, Gaza Province, Mozambique
- Tinpswalo Association, Research Unit, Vincentian Association to Fight AIDS and TB, Chókwè, Gaza Province, Mozambique
| | - José-Manuel Ramos-Rincón
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain.
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain.
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Wakibi S, Ferguson L, Berry L, Leidl D, Belton S. Teaching evidence-based nursing practice to student nurses in developing countries: strategies for novice nurse educators. Int J Nurs Educ Scholarsh 2020; 17:/j/ijnes.ahead-of-print/ijnes-2019-0042/ijnes-2019-0042.xml. [PMID: 32804677 DOI: 10.1515/ijnes-2019-0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/28/2020] [Indexed: 11/15/2022]
Abstract
Introduction Globally, Evidence based nursing practice (EBNP) is becoming an expected norm for nursing practice. The small-scale activities surrounding this practice in African countries indicate a need for better approaches to enhance EBNP. One of these approaches is strengthening nursing education through EBNP education. Objectives The purpose of this paper is to provide strategies to African novice nurse educators to teach EBNP, with the ultimate goal of promoting it in clinical settings when the student nurses enter professional practice. Methods This is a discussion paper based on the results of a systematic review. Results In this paper, the authors create an understanding of EBNP, describe the state of nursing education in Africa, and propose the EBNP content to be taught as well as how to teach it. Conclusions Emphasis is on educational strategies that create student engagement, promote critical thinking, unite clinical and classroom settings, and are cost-effective within the context of Africa.
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Affiliation(s)
| | | | - Lois Berry
- University of Saskatchewan, Saskatoon, SK, Canada
| | - Don Leidl
- University of Saskatchewan, Saskatoon, SK, Canada
| | - Sara Belton
- University of Saskatchewan, Saskatoon, SK, Canada
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20
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Dede Yildirim E, Roopnarine JL, Abolhassani A. Maternal use of physical and non-physical forms of discipline and preschoolers' social and literacy skills in 25 African countries. Child Abuse Negl 2020; 106:104513. [PMID: 32470690 DOI: 10.1016/j.chiabu.2020.104513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/15/2020] [Accepted: 04/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Little is known about associations between different forms of discipline and children's literacy, social skills, and behavior in low- and middle-income countries. This study examined maternal use of physical discipline, harsh physical discipline, psychological aggression, and nonphysical discipline and their relative associations with preschool-aged children's social and literacy skills and behavioral difficulty in 25 diverse African countries. We also explored whether belief in physical discipline and sociodemographic factors moderate the associations between different forms of discipline and childhood outcomes. METHODS The participants were 32,817 biological mothers and their preschool-aged children from the UNICEF Multiple indicator Cluster Surveys. Information regarding belief in and use of physical and nonphysical forms of discipline and children's social and literacy skills and behavioral difficulty were obtained via questionnaires obtained from mothers in each household. RESULTS Psychological aggression was negatively, and nonphysical discipline positively associated with children's literacy skills. Harsh physical discipline, physical discipline, and psychological aggression were positively, and nonphysical discipline negatively associated with behavioral difficulty in children. Psychological aggression, physical discipline, and nonphysical discipline were positively associated with and harsh physical discipline negatively associated with children's social skills. Maternal education, preschool enrollment, and household wealth variously moderated the associations between different modes of discipline and children's literacy and social skills and behavioral difficulty. CONCLUSIONS Findings underline the negative consequences of harsh discipline on children's social and literacy skills and behavioral difficulty in African cultural communities.
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Affiliation(s)
- Elif Dede Yildirim
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849, United States.
| | - Jaipaul L Roopnarine
- Department of Human Development and Family Science, Syracuse University, Syracuse NY, 13244, United States; Anton de Kom University of Suriname, Suriname
| | - Aida Abolhassani
- Department of Human Development and Family Science, Syracuse University, Syracuse NY, 13244, United States
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21
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Dogan E, Tzeremes P, Altinoz B. Revisiting the nexus among carbon emissions, energy consumption and total factor productivity in African countries: new evidence from nonparametric quantile causality approach. Heliyon 2020; 6:e03566. [PMID: 32258455 PMCID: PMC7109631 DOI: 10.1016/j.heliyon.2020.e03566] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/25/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
This study aims to contribute to the existing thin body of nonlinear causality literature by applying the new hybrid nonparametric quantile causality approach. In this line, we investigate the non-linear nexus among total factor productivity, energy consumption and carbon emissions for seventeen African countries. From the results, it is remarkable that there are generally strong causalities between the variables in the middle lower, middle upper and middle quantiles. Hence, energy consumption, environmental pollution and total factor productivity are closely linked in African countries. In particular, bidirectional linkage is detected between total factor productivity and energy consumption for Angola, Benin, Botswana, Cote d'Ivoire, Kenya, Morocco, Egypt, Nigeria and Tunisia. Studying the relationship between total factor productivity and emissions again at the middle quantile bidirectional causal ordering is documented almost for all the countries. Lastly and regarding the linkage between energy consumption and carbon emissions, a strong bidirectional ordering between the two variables is confirmed for Angola, Benin, Cote d'Ivoire, Cameroon, Kenya, Morocco, Egypt, Mozambique, Nigeria, Senegal and Tunisia. We can notice that an increase in economic development is critical for these countries; a number of regulatory policies for environmental problems and energy consumption are required during this development.
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Affiliation(s)
- Eyup Dogan
- Department of Economics, Abdullah Gul University, Turkey
| | | | - Buket Altinoz
- Vocational School, Nisantasi University, Istanbul, Turkey
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22
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Abstract
Background The report from the World Health Organization (WHO) reveals that health spending worldwide remains highly unequal as more than 80% of the world's population live in low and middle-income countries but only account for about 20% of global health expenditure. Another report by the WHO on the state of health financing in Africa published in 2013 intimates that countries that are part of their member states are still on the average level in meeting set goals in financing key health projects. Objective The study set out to investigate the association between public and private spending and health status for eight selected African countries, namely Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Sudan, Tanzania and Uganda. Health status indicators include the incidence of tuberculosis, mortality rates, maternal deaths and prevalence of HIV. Methods Descriptive statistics and pairwise correlation are used to assess the relationship between healthcare spending and health status. Random and fixed effect models are further employed to provide insights into the association between descriptive statistics and pairwise correlation. We used annual data from the year 2000 to 2014 obtained from world development indicators. Results The relationship between healthcare spending (public and private) and health status is statistically significant. Public healthcare expenditure has a higher association than private expenditure in reducing the mortality rate, tuberculosis and HIV for the average country in our sample. For example, an increase in public healthcare spending is negatively associated and statistically significant at 5% or better in reducing female mortality, male mortality, tuberculosis and HIV. Private healthcare spending is more impactful in the area of maternal deaths, where it is associated negatively and statistically significant at 1%. An increase in private healthcare spending is linked to a reduction in maternal deaths. We also compared the association between an increase in healthcare spending on males versus females and observed that public health expenditure impacts the health status of both sexes equally, however, private health expenditure provides a greater positive benefit to males. It is worth remembering that two goals of the United Nations agenda on sustainable development are gender equality and ensuring healthcare for all. Conclusion The findings of this research call for the selected African countries to pay more attention to public healthcare expenditure in order to improve health status, especially since private healthcare which provides access to healthcare facilities for some poor people leads to costs that are a burden. So, future research should focus on analyzing components of private healthcare spending such as direct household out-of-pocket spending, private insurance and direct service payments by private corporations as dependent variables to understand what form of private investment should be encouraged.
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Affiliation(s)
- Murad Bein
- Department of Accounting and Finance, Faculty of Economics and Administrative Sciences, Cyprus International University
| | - Elizabeth Y Coker-Farrell
- Department of Business Administration, Faculty of Economics and Administrative Sciences, Cyprus International University
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Okyere C, Aldersey HM, Lysaght R, Sulaiman SK. Implementation of inclusive education for children with intellectual and developmental disabilities in African countries: a scoping review. Disabil Rehabil 2018; 41:2578-2595. [PMID: 29693469 DOI: 10.1080/09638288.2018.1465132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: To advance understanding of practices that support inclusion of children with intellectual and developmental disabilities in inclusive education classrooms in Africa by conducting a review of the extant literature. Methods: Five academic databases were searched supplemented by a hand search of key journals and references of included studies. Two authors independently screened studies via a reference manager (Covidence) which allowed for blinding. A third author was consulted in cases of conflict. Results: Thirty articles that provided empirical evidence of inclusive education implementation were included. Eight articles highlighted practices that support inclusion of children with intellectual and developmental disabilities. Using Bronfenbrenner's bioecological framework, findings revealed that inclusive education implementation is influenced by factors on the bio level, micro level, meso level, and macro level. Recommendations for promoting inclusive education implementation are provided. Conclusions: Inclusion goes beyond teachers and requires strong commitment of other stakeholders such as families and governments. To guarantee the smooth inclusion of children with special education needs and particularly with intellectual and developmental disabilities, a set of practices validated through rigorous research as supportive and unique and that can be universal to Africa is wise. Implications for rehabilitation A number of strategies were identified that can improve the classroom inclusion of children with intellectual and developmental disabilities. Development of policies that support such strategies could improve implementation. Inclusion goes beyond teachers. Rehabilitation professionals (i.e. occupational therapists) and educational professionals should partner to identify practical solutions to the challenges of creating inclusive environments for children with special education needs. Committing more resources and time towards the development and implementation of special education policies can advance the successful inclusion of children with special education needs.
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Affiliation(s)
- Christiana Okyere
- School of Rehabilitation Therapy, Queen's University , Kingston , ON , Canada
| | | | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen's University , Kingston , ON , Canada
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24
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Henríquez-Hernández LA, Luzardo OP, Boada LD, Carranza C, Pérez Arellano JL, González-Antuña A, Almeida-González M, Barry-Rodríguez C, Zumbado M, Camacho M. Study of the influencing factors of the blood levels of toxic elements in Africans from 16 countries. Environ Pollut 2017; 230:817-828. [PMID: 28734263 DOI: 10.1016/j.envpol.2017.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/03/2017] [Accepted: 07/12/2017] [Indexed: 06/07/2023]
Abstract
Africa's economy is growing faster than any other continent and it has been estimated that the middle class in Africa now exceeds 350 million people. This has meant a parallel increase in the importation of consumer goods and in the implementation of communication and information technologies (ICT), but also in the generation of large quantities of e-waste. However, inadequate infrastructure development remains a major constraint to the continent's economic growth and these highly toxic residues are not always adequately managed. Few studies have been conducted to date assessing the possible association between socioeconomic development factors, including e-waste generation, and blood levels of inorganic elements in African population. To disclose the role of geographical, anthropogenic, and socioeconomic development determinants on the blood levels of Ag, Al, As, Be, Cd, Co, Cr, Hg, Ni, Pb, Sb, and V -all of them frequently found in e-waste-, an immigrant population-based study was made including a total of 245 subjects from 16 countries recently arrived to the Canary Islands (Spain). Women presented higher levels of blood elements than men, and Northern Africans (Moroccans) were the most contaminated. People from low-income countries exhibited significantly lower blood levels of inorganic elements than those from middle-income countries. We found a significant association between the use of motor vehicles and the implementation of information and communication technologies (ICT) and the level of contamination. Immigrants from the countries with a high volume of imports of second-hand electronic equipment, telephone and internet use had higher levels of inorganic elements. In general terms, the higher level of economic development the higher the blood levels of inorganic pollutants, suggesting that the economic development of Africa, in parallel to e-waste generation and the existence of informal recycling sites, have directly affected the level of contamination of the population of the continent.
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Affiliation(s)
- Luis Alberto Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Octavio P Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain.
| | - Luis D Boada
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERObn), Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Cristina Carranza
- Infectious Diseases and Tropical Medicine Unit, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Medical Sciences and Surgery Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - José Luis Pérez Arellano
- Infectious Diseases and Tropical Medicine Unit, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain; Medical Sciences and Surgery Department, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ana González-Antuña
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Maira Almeida-González
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Carlos Barry-Rodríguez
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
| | - María Camacho
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe s/n, 35016 Las Palmas, Spain
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Vila-Real C, Pimenta-Martins A, Gomes AM, Pinto E, Maina NH. How dietary intake has been assessed in African countries? A systematic review. Crit Rev Food Sci Nutr 2017; 58:1002-1022. [PMID: 27996293 DOI: 10.1080/10408398.2016.1236778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. OBJECTIVE To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. METHODS A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. FINDINGS Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. CONCLUSIONS There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.
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Affiliation(s)
- Catarina Vila-Real
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Pimenta-Martins
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Maria Gomes
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Elisabete Pinto
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal.,b Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal
| | - Ndegwa Henry Maina
- c Division of Food Technology, Department of Food and Environmental Sciences , University of Helsinki , Helsinki , Finland
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Rossow I, Clausen T. The collectivity of drinking cultures: is the theory applicable to African settings? Addiction 2013; 108:1612-7. [PMID: 23668554 DOI: 10.1111/add.12220] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 01/16/2013] [Accepted: 04/10/2013] [Indexed: 11/28/2022]
Abstract
AIMS Skog's theory of collective drinking behaviour implies that countries with a strict informal social control of drinking alcohol would not exhibit 'collective displacement' of consumption (a linear association between population mean consumption and percentile values across the full range of the distribution), as do countries with less informal social control. This paper aimed to test this hypothesis by examining the alcohol consumption distributions in African countries with a strong informal control of alcohol. DESIGN SETTING, PARTICIPANTS AND MEASUREMENTS Data on alcohol consumption from the World Health Organization's general population surveys in 15 African countries were aggregated and analysed with respect to skewedness and collective displacement of the distribution. FINDINGS The distribution of consumption was strongly positively skewed, with 10-15% of the drinkers consuming more than twice the mean consumption. There was also clear evidence of a collective displacement of the consumption distribution, and the consumption mean was a strong predictor of the distribution percentile values across the full range of the distribution. Correspondingly, consumption mean predicted the prevalence of heavy drinkers. CONCLUSION The distribution patterns of alcohol consumption in African countries are consistent with those observed previously in industrialized countries. These findings seem to counter Skog's theory of collective drinking behaviour and support the universality of the observation that the prevalence of problem drinking is linked closely to mean consumption.
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Affiliation(s)
- Ingeborg Rossow
- Norwegian Institute for alcohol and Drug Research, Øvre Slotts gt 2, Oslo, Norway.
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Peltzer K. Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries. Afr Health Sci 2011; 11:320-328. [PMID: 22275919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE This report examines the prevalence and common correlates of early smoking initiation among male and female school children across seven African countries. METHOD The total sample included 17,725 school children aged 13 to 15 years from nationally representative samples in seven African countries. Univariate and multivariate analyses were conducted to assess the relationship between early smoking initiation, health compromising behaviours, mental distress, protective factors and socio-economic status variables. RESULTS Overall 15.5% had experienced smoking initiation before age 14, with the percentages 20.1% among boys and 10.9% among girls. In multivariable analysis, early smoking initiation was among boys associated with ever drunk from alcohol use (OR = 4.73, p = 0.001), ever used drugs (OR = 2.36, p = 0.04) and ever had sex (OR = 1.63, p = 0.04). Among girls, it was associated with higher education (OR = 5.77, p = 0.001), ever drunk from alcohol use (OR = 4.76, p = 0.002), parental or guardian tobacco use (OR = 2.83, p = 0.001) and suicide ideation (OR = 2.05, p = 0.02). CONCLUSION The study found a high prevalence of early smoking initiation among 13-15 year-olds in seven African countries. Various risk factors have been identified in boys and girls who initiate smoking before age 14, forming a distinct risk group in this setting. Specific interventions are needed for boys and girls in the preteen years, before smoking initiation.
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Affiliation(s)
- K Peltzer
- HIV/AIDS/STI/and TB, Human Sciences Research Council, Pretoria, South Africa.
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